1. Management of hypovitaminosis D in patients with primary hyperparathyroidism
- Author
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S. Gonzalez, S. R. Peacey, N. R. Ellis, M. S. Rathi, and D. Wright
- Subjects
Adult ,Male ,Vitamin ,medicine.medical_specialty ,Hypercalcaemia ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Parathyroid hormone ,Severity of Illness Index ,Gastroenterology ,vitamin D deficiency ,Cohort Studies ,chemistry.chemical_compound ,Endocrinology ,Internal medicine ,medicine ,Vitamin D and neurology ,Humans ,Secondary Care Centers ,Aged ,Calcifediol ,Cholecalciferol ,Aged, 80 and over ,Hyperparathyroidism ,business.industry ,Middle Aged ,Hyperparathyroidism, Primary ,Vitamin D Deficiency ,medicine.disease ,United Kingdom ,chemistry ,Parathyroid Hormone ,Dietary Supplements ,Hypercalcemia ,Calcium ,Female ,business ,Biomarkers - Abstract
Epidemiological studies suggest that vitamin D deficiency is common in patients with primary hyperparathyroidism (PHPT). They have higher levels of serum parathyroid hormone (PTH) and markers of bone turnover and fractures are more frequent than vitamin D-replete patients. However, there are concerns that Vitamin D repletion might exacerbate pre-existent hypercalcaemia. Therefore, we aimed to determine if vitamin D replacement improved biochemical indices of calcium metabolism without worsening underlying hypercalcaemia. This is a prospective, observational study based on routine clinical practice, set up in a secondary care centre. 45 consecutive patients with mild biochemical hypercalcaemia due to PHPT and hypovitaminosis D were enrolled. The mean age of the cohort was 61 years (range 25–85 years), predominately Asian (32 patients) and female (41 patients). They received 20,000 IU of oral cholecalciferol, once a week, for 3 months. Calcium, phosphate, alkaline phosphatase and PTH were measured at baseline, 4, 8 and 12 weeks following treatment. Vitamin D levels were obtained at baseline and at 12 weeks, after they completed their treatment. Vitamin D levels normalised at week 12 (mean ± SD, 18.8 ± 9.4 versus 76 ± 20 nmol/L, p = 0.0001) and PTH levels improved following treatment completion (21.2 ± 10 versus 16.2 ± 6 pmol/L, p = 0.026). There was no significant increase in serum calcium levels during vitamin D supplementation. High doses of oral cholecalciferol normalised vitamin D levels without worsening underlying hypercalcaemia in individuals with PHPT.
- Published
- 2014
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